Finding the palpatory systole (cut off pressure) will give you a number to go 30 - 50 mmHg above when you take the blood pressure for real. This way, especially if you go 50 mmHg above the palpatory systole, will ensure that you don't miss an auscultatory gap. You cannot palpate the auscultatory gap. You have to detect this with your stethoscope.
Yes sir agreed it can avoid false systolic pressure estimation by going suprasystolically but when the auscultatory gap is there lets say an example of a person with malignant htn, 190/110mm Hg is his actual sbp/dbp and auscultatory gap appears around 150-130 mmHg so during that time the false systole is only avoided but we take 130 as per auscultatory method even if we are palpating the pulse first right
Hello, Great question! if you find the cutoff pressure (which is usually systole) and then go 50 mmHg above that, then you will not be fooled by an auscultatory gap when detecting systole. For example, if the cutoff pressure is 120, then you should pump up to 170 before you start letting air out of the cuff and taking the blood pressure.
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Hello, sir! I'm curious, does the auscultatory gap happen only once when taking the blood pressure? Or can it happen twice?
Only once.
Hi sir, so does doing the palpatory method first avoid this auscultatory gap. Also is this gap seen during palpation by disappearance of pulse felt?
Finding the palpatory systole (cut off pressure) will give you a number to go 30 - 50 mmHg above when you take the blood pressure for real. This way, especially if you go 50 mmHg above the palpatory systole, will ensure that you don't miss an auscultatory gap.
You cannot palpate the auscultatory gap. You have to detect this with your stethoscope.
Yes sir agreed it can avoid false systolic pressure estimation by going suprasystolically but when the auscultatory gap is there lets say an example of a person with malignant htn, 190/110mm Hg is his actual sbp/dbp and auscultatory gap appears around 150-130 mmHg so during that time the false systole is only avoided but we take 130 as per auscultatory method even if we are palpating the pulse first right
This can lead to false estimation of dbp as 130 mmHg instead of 110mmHg
So with people who have auscultatory gap, will the cut off pressure or two step method not work to catch the proper systolic number?
Hello, Great question!
if you find the cutoff pressure (which is usually systole) and then go 50 mmHg above that, then you will not be fooled by an auscultatory gap when detecting systole. For example, if the cutoff pressure is 120, then you should pump up to 170 before you start letting air out of the cuff and taking the blood pressure.
@@douglasgillarddcprofessoro5285 thank you I will see what I can do using my 84 year old mother (who has auscultatory gap) as a Guinea pig.
Thanks sir